Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block

Abstract Left bundle branch block (LBBB) causes left ventricular (LV) dyssynchrony which is often associated with heart failure. A significant proportion of heart failure patients do not demonstrate clinical improvement despite cardiac resynchronization therapy (CRT). How LBBB-related effects on LV...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jonatan Eriksson, Jakub Zajac, Urban Alehagen, Ann F. Bolger, Tino Ebbers, Carl-Johan Carlhäll
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c6b5e1f66d6843dcb07838d9d8d45d90
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c6b5e1f66d6843dcb07838d9d8d45d90
record_format	dspace
spelling	oai:doaj.org-article:c6b5e1f66d6843dcb07838d9d8d45d902021-12-02T15:05:44ZLeft ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block10.1038/s41598-017-03089-x2045-2322https://doaj.org/article/c6b5e1f66d6843dcb07838d9d8d45d902017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-03089-xhttps://doaj.org/toc/2045-2322Abstract Left bundle branch block (LBBB) causes left ventricular (LV) dyssynchrony which is often associated with heart failure. A significant proportion of heart failure patients do not demonstrate clinical improvement despite cardiac resynchronization therapy (CRT). How LBBB-related effects on LV diastolic function may contribute to those therapeutic failures has not been clarified. We hypothesized that LV hemodynamic forces calculated from 4D flow MRI could serve as a marker of diastolic mechanical dyssynchrony in LBBB hearts. MRI data were acquired in heart failure patients with LBBB or matched patients without LBBB. LV pressure gradients were calculated from the Navier-Stokes equations. Integration of the pressure gradients over the LV volume rendered the hemodynamic forces. The findings demonstrate that the LV filling forces are more orthogonal to the main LV flow direction in heart failure patients with LBBB compared to those without LBBB during early but not late diastole. The greater the conduction abnormality the greater the discordance of LV filling force with the predominant LV flow direction (r2 = 0.49). Such unique flow-specific measures of mechanical dyssynchrony may serve as an additional tool for considering the risks imposed by conduction abnormalities in heart failure patients and prove to be useful in predicting response to CRT.Jonatan ErikssonJakub ZajacUrban AlehagenAnn F. BolgerTino EbbersCarl-Johan CarlhällNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jonatan Eriksson Jakub Zajac Urban Alehagen Ann F. Bolger Tino Ebbers Carl-Johan Carlhäll Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block
description	Abstract Left bundle branch block (LBBB) causes left ventricular (LV) dyssynchrony which is often associated with heart failure. A significant proportion of heart failure patients do not demonstrate clinical improvement despite cardiac resynchronization therapy (CRT). How LBBB-related effects on LV diastolic function may contribute to those therapeutic failures has not been clarified. We hypothesized that LV hemodynamic forces calculated from 4D flow MRI could serve as a marker of diastolic mechanical dyssynchrony in LBBB hearts. MRI data were acquired in heart failure patients with LBBB or matched patients without LBBB. LV pressure gradients were calculated from the Navier-Stokes equations. Integration of the pressure gradients over the LV volume rendered the hemodynamic forces. The findings demonstrate that the LV filling forces are more orthogonal to the main LV flow direction in heart failure patients with LBBB compared to those without LBBB during early but not late diastole. The greater the conduction abnormality the greater the discordance of LV filling force with the predominant LV flow direction (r2 = 0.49). Such unique flow-specific measures of mechanical dyssynchrony may serve as an additional tool for considering the risks imposed by conduction abnormalities in heart failure patients and prove to be useful in predicting response to CRT.
format	article
author	Jonatan Eriksson Jakub Zajac Urban Alehagen Ann F. Bolger Tino Ebbers Carl-Johan Carlhäll
author_facet	Jonatan Eriksson Jakub Zajac Urban Alehagen Ann F. Bolger Tino Ebbers Carl-Johan Carlhäll
author_sort	Jonatan Eriksson
title	Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block
title_short	Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block
title_full	Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block
title_fullStr	Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block
title_full_unstemmed	Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block
title_sort	left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/c6b5e1f66d6843dcb07838d9d8d45d90
work_keys_str_mv	AT jonataneriksson leftventricularhemodynamicforcesasamarkerofmechanicaldyssynchronyinheartfailurepatientswithleftbundlebranchblock AT jakubzajac leftventricularhemodynamicforcesasamarkerofmechanicaldyssynchronyinheartfailurepatientswithleftbundlebranchblock AT urbanalehagen leftventricularhemodynamicforcesasamarkerofmechanicaldyssynchronyinheartfailurepatientswithleftbundlebranchblock AT annfbolger leftventricularhemodynamicforcesasamarkerofmechanicaldyssynchronyinheartfailurepatientswithleftbundlebranchblock AT tinoebbers leftventricularhemodynamicforcesasamarkerofmechanicaldyssynchronyinheartfailurepatientswithleftbundlebranchblock AT carljohancarlhall leftventricularhemodynamicforcesasamarkerofmechanicaldyssynchronyinheartfailurepatientswithleftbundlebranchblock
_version_	1718388731999682560

Left ventricular hemodynamic forces as a marker of mechanical dyssynchrony in heart failure patients with left bundle branch block

Ejemplares similares